N455Remark Code (RARC)Active
N455 Remark Code - Missing Physician Order Explanation
The N455 remark code indicates that there is a missing physician order related to the claim. This remark supplements a claim adjustment reason code that suggests the service billed requires a physician's order, which has not been provided.
How It Relates to the Denial
The N455 remark typically accompanies adjustment reason codes that indicate a service was denied due to lack of supporting documentation, particularly regarding physician orders. This combination signals that additional information is needed to substantiate the claim.
Common Scenarios
1A physical therapy claim was submitted, but the remittance shows an adjustment indicating it was denied due to lack of a physician's order.
→ The N455 remark code highlights that the payer requires proof of a physician's order to process the claim. You need to provide this documentation to support the claim.
2An imaging service was billed, and the remittance indicates a denial for insufficient documentation along with the N455 remark code.
→ In this case, the N455 remark suggests that the imaging service cannot be processed because the necessary physician order was not included with the claim.
3A laboratory test claim was submitted without a physician's order, resulting in a denial and the appearance of the N455 remark code on the remittance.
→ The N455 remark is alerting you that the claim is incomplete due to the absence of a physician order, which is essential for the billed service.
What to Do
- Obtain the missing physician order from the provider.
- Submit the physician order along with the claim for reconsideration.
- Ensure the order is dated and specifies the service that was performed.
What to Check
- Review the claim submission for any documentation that may have been omitted.
- Check the provider's notes or records for the physician's order related to the service.
- Confirm the payer's requirements for documentation to ensure compliance.